| John C Lincoln Llc | |
|
19636 N 27th Ave Suite 308 Phoenix AZ 85027-4013 | |
| (623) 780-1999 | |
| (623) 516-0950 |
| Full Name | John C Lincoln Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 19636 N 27th Ave, Phoenix, Arizona |
| Authorized Official Name and Position | Savas Petrides (SVP/CEO) |
| Authorized Official Contact | 4806964020 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John C Lincoln Llc 2500 W Utopia Rd Phoenix AZ 85027-4171 Ph: (480) 587-5314 | John C Lincoln Llc 19636 N 27th Ave Suite 308 Phoenix AZ 85027-4013 Ph: (623) 780-1999 |
| NPI Number | 1073691093 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 10/02/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073691093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | OTC 2379 (Arizona) | Primary |
| 261QR0200X | Clinic/center - Radiology | OTC3148 (Arizona) | Secondary |
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